Tag Archives: Child Stress

BPD And Childhood Trauma

One of the things that frequently marks the childhood of individuals who later develop BPD is LOSS, especially when the loss has occurred as a result of death, divorce or serious illness (necessitating long periods in hospital). In one particular research study looking at this, it was found that three-quarters of those suffering from BPD had experienced such losses in childhood.

Abuse also plays a large part in the development of BPD. One study found that 75% of those suffering from BPD had experienced sexual abuse during their childhood compared to 33% of those who suffered from other psychiatric conditions.

However, it is not just obvious trauma in childhood that is linked to the later development of BPD. More subtle forms of problematic parenting also put the child at risk. Examples of this include:

– the parent/s emotionally withdrawing from the child
– inconsistent parenting (eg praise and punishment being distributed in an UNPREDICTABLE manner)
– parent/s discounting, belittling or ignoring the child’s feelings

Another form of problematic parenting which has been linked to the child later developing BPD include:

– the parent behaving too much like a friend rather than a responsible, caring figure
– turning the child into a CONFIDANT
– role reversal : treating the child like a parent

OBJECT RELATIONS THEORY:

Parenting problems are so closely tied to putting the child at risk of later developing BPD because as illustrated, for example, by object relations theory, the way a parent brings up a child has a critical influence on the way the child develops, especially in relation to the following:

– how the child goes on to see him/herself (self-identity, self-concept)
– how the child goes on to view others
– how the child goes on to deal with relationships (functioning in this area often becomes deeply impaired).

The theory suggests, then, that problematic parenting can lead to the child developing identity problems later on together with problems of self-image (affected children will often later develop a view of themselves as ‘bad’, or, even, ‘evil’) with concordant effects upon behavior. Often, also, a feeling of profound HELPLESSNESS will develop.

In relation to how the affected child sees others, certain patterns have been found to emerge. For example, the child may develop into an adult who deeply mistrusts those in authority, viewing them as overwhelmingly vindictive, malicious and punitive. Interestingly, also, however, there can develop a tendency to IDEALIZE people of importance to him/her in the initial stages of knowing them; because, however, this is likely to lead to UNREALISTIC EXPECTATIONS of the one who has been idealized (especially in relation to them – the idealized one, that is – being able to protect and nurture them) when these high expectations are not lived up to the failure gives rise to feelings of having been BETRAYED in the one who had those expectations.

In conclusion, it should be pointed out that a very difficult childhood does not guarantee the later development of BPD, but risk is elevated if the individual also has a genetic disposition to developing emotional problems.

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Childhood Trauma And Defense Mechanisms

In response to stress resulting from our childhood trauma and other factors we often develop psychological DEFENSE MECHANISMS in an attempt to protect ourselves (though, very often, we are not consciously aware that many behaviours/defense mechanisms we have developed have developed in order to try to reduce the adverse effects of stress (though not all, eg CONVERSION – see below).

Often, however, the behaviours we develop which serve as these defense mechanisms to protect ourselves against stress are, at best, unhelpful, and, at worst, extremely damaging. I list and give a brief description of the main defence mechanisms that may develop below:

1) COMPENSATION: this behaviour occurs to offset a weakness or failing in ourselves eg someone who has very low self-esteem becoming a workaholic in an attempt to gain social status.

3) DENIAL : this defense mechanism is well known and the term has entered into the realms of popular vocabulary. It refers to a situation in which someone will not acknowledge something is wrong (eg after being told by a doctor one has only 3 months to live).

4) DISPLACEMENT : this is when we transfer the emotions we feel caused by one person onto somebody else who has nothing to do with how we’re feeling eg a man badly treated by his boss at work coming home and taking his anger and frustration out on his children.

5) DISSOCIATION : this is when we avoid examining how our behaviours relate to our beliefs by avoiding looking, too closely, at this relationship eg seeing ourselves as caring and compassionate but doing little or nothing to help others

6) FIXATION : this is when we have behaviours which stay fixed at an earlier stage of development and are therefore not appropriate to the life stage the individual is at eg a middle-aged remaining highly emotionally dependent upon his parents

7) IDENTIFICATION : this is when we behave, dress etc in a way which duplicates the way the person we are modelling ourselves on would behave and dress etc (this can occur on both conscious and unconscious levels and is not considered abnormal in young people).

8) INTROJECTION : this is when we turn our feelings towards others onto ourselves. Freud, for example, believed someone who is clinically depressed has, unconsciously, turned his/her anger with another/others onto himself and is, therefore, in effect, punishing him/herself with his/her depressive feelings in a way he/she unconsciously wishes to inflict upon others.

9) INVERSION : this is where we REPRESS a desire which we are uncomfortable having and act in a way which expresses the opposite eg a repressed homosexual who acts in an obsessively homophobic manner. This often occurs on an unconscious level.

10) PROJECTION : this is really the opposite of introjection (see above). It is where we constantly see faults in others which we, ourselves, are ashamed of and feel guilty about having eg constantly pointing out selfishness in others when we ourselves are ashamed of our own selfishness. Again, this can occur on an unconscious level.

11) RATIONALIZATION : this is when we, in effect, deceive ourselves and tell ourselves that something we have, in fact, done due to bad motives we have really done for socially acceptable reasons eg a man who divorces his wife and leaves his young family may tell himself it’s in the best interests of everyone, when, really, deep down, he is doing it purely in his own interest

12) REGRESSION : this is when we go back to behaving in a way that is no longer appropriate and would usually only occur at a much younger age eg a middle-aged man having a child-like tantrum.

13) REPRESSION : this is when we, unconsciously, bury feelings and attitudes which are unacceptable to us, and contrary to our moral beliefs, deep in the mind away from conscious access eg an illicit sexual attraction. When we consciously bury feelings that we are not comfortable with (often referred to in popular language as ‘putting something to the back of our mind’) it is called SUPPRESSION.

14) RESISTANCE : this is where there is a barrier between what we have repressed/banished into the unconscious mind. In other words, what we have repressed is not allowed conscious access. Freud believed this process meant the psychological tension produced by keeping the feeling, memory etc repressed can’t be resolved and so perpetuates the emotional pain that the individual is feeling.

15) SUBLIMATION : this is where the energy associated with feelings that are unacceptable to us (usually sexual, according to Freud) and buried in the unconscious mind is channeled into something else that is socially acceptable. Unlike many of the other defence mechanisms that I have described, this can be very positive, and, even, Freud thought, produce great art.

16) TRANSFERENCE : this is where feelings and emotions we have about a particular individual are transferred onto somebody else who was not the original cause of them. For example, an individual in therapy who transfers the feelings of hatred he feels towards his mother onto the therapist.

17) WITHDRAWAL : this is when we just cut off from a stressful situation, give up, lose interest and become apathetic eg a man who stops trying to make conversation with his wife or take any interest in her after the relationship has been very difficult for a long period of time and he can no longer cope with it

Recent research has led to an expansion of the description of the main borderline personality disorder (BPD) symptoms. Following the development of the Sheldern Western Assessment Procedure 200 (an assessment tool which includes 200 questions that aid in the diagnosis of BPD) experts, based on up-to-date research, have now developed a much more detailed and comprehensive list of symptoms of BPD than used to be the case.

The list is published in a book by Patrick Kelly and Francis Mondimore -called Borderline Personality Disorder – New Reasons For Hope – who are experts in the field of BPD. I reproduce the list of symptoms in full below:

– INABILITY TO REGULATE EMOTIONS : emotions change rapidly and unpredictably; emotions tend to spiral out of control leading to extremes in feelings of anxiety, sadness, rage, excitement; inability to self-soothe when distressed so requires involvement of others ; tends to catastrophize and see problems as unsolvable disasters ; tends to become irrational when emotions stirred up which can lead to a drop in the normal level of functioning ; tends to act impulsively without regard for the consequences

– BECOMES EMOTIONALLY ATTACHED TO OTHERS QUICKLY AND INTENSELY : develops feelings and expectations of others not warranted by history or context of the relationship ; expects to be abandoned by those s/he is emotionally close to ; feels misunderstood, mistreated and victimized ; simultaneously needy and rejecting of others (craves intimacy and caring but tends to reject it when it is offered) ; interpersonal relationships unstable, chaotic and rapidly changing.

– DAMAGED SENSE OF SELF : lacks stable self-image ; attitudes, values, goals and feelings about self may be unstable and changing ; feels inadequate, inferior and like a failure ; feels empty ; feels helpless, powerless and at mercy of outside forces ; feels like an outsider who does not belong ; overly needy and dependent ; needs excessive reassurance and approval.

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What Causes An Excessive Need For Approval?

If we did not receive approval from those close to us in childhood we may grow up to have an excessive need for it from others later in life as a kind of compensation and in order to raise our shattered self-esteem. This can make us vulnerable and excessively anxious to make everybody like us and admire us. Of course, this is impossible to achieve.

It is just not possible to interact fully in society without sometimes experiencing disapproval and rejection. Very often, such rejection and disapproval does not mean that there is anything particularly wrong with us.

Indeed, it could be much more to do with failings in the other person, obvious examples are prejudice, discrimination, biased and irrational thinking or misdirection of emotions which were not originally generated by us (eg ‘displacenment’ – the psychological term for when somebody takes something out on us which was not our fault; or ‘projection’ -the psychological term for constantly ‘seeing’ in other people the things we don’t like about ourselves and may have repressed).

Frequently, too, a person’s behaviour towards us might be due to distorted beliefs stemming from psychological wounds that have been inflicted upon them in the past (eg a woman who distrusts men because her husband used to beat her).

When we are (inevitably) sometimes rejected, a useful exercise is to calmly think about why we have been responded to in a negative manner and analyze if it really was something to do with us or to do with something else not really connected to us.

For example, perhaps the person who behaved in a negative way towards us was over-tired or under a great amount of stress. In such a case, the disapproval is likely to be ephemeral, in any event, and something we do not need to dwell upon or take personally.

Obviously, when someone rejects us it does not mean that we are of no value. Even if we have done something wrong, one action or set of actions does not define us as a person (either in the present or in the future). To become defined in such a way would be absurdly limiting and simplistic. Human beings are, after all, complex creatures (hence expressions like : ‘he’s the sum of his contradictions’).

Individuals who have an excessive need for approval often feel that it is imperative that EVERYBODY approves of them. I repeat, this is impossible, and, in my view, undesirable (often, history has shown us, the most enlightened and edifying views can meet with vicious opposition). We do not need the approval of everyone we meet in order to live a happy and meaningful life. Also, other people’s views of us should not be given equal weight (eg most of us would value the view someone we respected had of us more than the view a stranger had).

It is also important to point out that we can sometimes feel hurt and upset if someone criticizes us in a mannner which we do not feel is warranted – to avoid falling into such a trap we need to remind ourselves that we need not let our mood be affected adversely by something negative someone says about us if we know it not to be true.

Finally, it is worth saying how it might be helpful to react when someone disapproves of us when we HAVE done something we regret. A constructive response might be as follows:

a) we can learn from the criticism

b) just because we know we have done something wrong, it is illogical to overgeneralize from this and view ourselves as a wholly bad person

c) accept that we feel temporarily uncomfortable but to keep in mind, too, that this feeling will pass and that we are not necessarily being totally written off as a person by the individual we have upset, let alone by everybody else for evermore!

Due to the side-effects associated with anti-depressants, together with the controversy which surrounds their effectivenes, some individuals prefer to try to treat their depression in more natural ways; in relation to this, many people adjust their intake of nutrients in ways which research suggests may lift their mood. I examine the foods and nutients which may help this goal to be achieved below:

FOODS AND NUTRIENTS WHICH MAY HELP TO LIFT MOOD :

Not only does some research suggest that the foods and nutrients listed below may help lift mood when depressed, it suggests they may also make depression less likely to recur once feeling better:

1) SELENIUM : this can be found in oysters, mushrooms and Brazil nuts

2) CHROMIUM : this can be found in turkey and green vegetables

3) ZINC : this can be found in shellfish, seafood and eggs

All of the above nutients can also be bought in supplement form from chemists and health food shops. However, they should not be taken in large doses so be sure to read the relevant labels to obtain the recommended amounts to take.

4) VITAMIN B12 : this vitamin, which can also be bought as a supplement from health shops and chemists, is thought to help maintain general mental alertness and, also, help keep feelings of depression at bay. It can be found in salmon, meat, cod, milk, cheese, eggs and yeast extract.

FISH

Some scientists recommend eating fish as a way of reducing depressive symptoms. The reason for this is that some research studies have provided evidence that FISH OILS have both an ANTI-DEPRESSANT and MOOD-STABILIZING effect. However, because of the amount of fish oil which needs to be ingested, one would have to consume a vast quantity of fish. In order to rectify this problem, many companies now produce FISH OIL CAPSULES (eg OMEGA – 3) as dietry SUPPLEMENTS. These contain very concentrated fish oil. However, more research needs to be conducted in order to come to a definitive verdict on their effectiveness. One benefit of them, however, is that they have no side-effects, apart from, rarely, a mildly upset stomach.

5-HTP

Otherwise known as HYDROXTRYPTOPHAN. The body manufactures this from tryptophan (an AMINO ACID) in the diet (sources include turkey and bananas) and it is linked to the production of SEROTONIN (a neurotransmitter which I discuss in other posts – please enter ‘SEROTONIN’ into this site’s search facility if you wish to access those posts) in the brain. Depleted serotonin levels in the brain are thought to be connected with depression and insomnia. Indeed, taking supplements of 5-HTP has been linked to not only helping to treat depression and insomnia, but, also, obesity.

The Cochrane Review (2001) found two studies suggesting that 5-HTP was more effective at treating depression than placebos, but, also, concluded that more research needed to be conducted in order to reach a proper conclusion in relation to how beneficial it is.

CONCLUSION:

A lot more research needs to be conducted in order to come to any definitive solutions about just how helpful diet, nutrients and supplements are at treating mental health conditions. However, there is a vast number of people who take them and are convinced of their effectiveness.

Finally, I wish to stress that it is extremely important to speak to a doctor if you are considering coming off any prescribed medication.